Depression among caregivers of children with asthma and its impact on communication with health care providers

Abstract

Background Caregiver depression is common, can negatively influence one's ability to communicate with healthcare providers, and may hinder appropriate care for children with asthma. Objective To evaluate the impact of caregiver depression on communication and self-efficacy in interactions about asthma with their child's physician. Study Design Cross sectional analysis using data from the Prompting Asthma Intervention in Rochester–Uniting Parents and Providers study. Methods We enrolled caregivers of children (2–12 yrs) with persistent asthma prior to their healthcare visit. Caregivers were interviewed via telephone after the visit to assess depression, self-efficacy, and provider communication at the visit. Caregiver depression was measured using the Kessler Psychological Distress scale. We assessed caregiver self-efficacy using items from the Perceived Efficacy in Patient Physician Interactions scale; caregivers rated their confidence for each item (range 0–10). We also inquired about how well the provider communicated regarding the child’s asthma care. Bivariate and multivariate analyses were used. Results We interviewed 195 caregivers (response rate 78%; 41% Black, 37% Hispanic), and 30% had depressive symptoms. Caregiver rating of provider communication did not differ by depression. Most caregivers reported high self-efficacy in their interactions with providers; however depressed caregivers had lower scores (8.7 vs. 9.4,p=.001) than non-depressed caregivers. Further, depressed caregivers were less likely to be satisfied with the visit (66% vs. 83%,p=.014), and to feel all of their needs were met (66% vs. 85%,p=.007). In multivariate analyses, depressed caregivers were >2× more likely to be unsatisfied with the visit and to have unmet needs compared to non-depressed caregivers. Conclusions Depressed caregivers of children with asthma report lower confidence in interactions with providers about asthma and are less likely to feel that their needs are met at a visit. Further study is needed to determine the best methods to communicate with and meet the needs of these caregivers.

Elevated Burden for Caregivers of Children with Persistent Asthma and a Developmental Disability

“…(6, 19–21) Some studies have been unable to establish a direct link between elevated caregiver burden and increased asthma symptom severity, though this may be due to the complex nature of pediatric asthma management. (18, 22) We found that caregivers of children with a DD reported worse psychological distress, however, there was no significant difference in asthma symptom severity, based on NHLBI criteria, between children with and without a DD. It is possible that our ability to detect differences in asthma severity was limited given that our sample only included children experiencing persistent symptoms.…”

“…(18) Although these are logical mechanisms for increased morbidity, (57, 58) recent studies have found mixed results. Several authors have reported that children with depressed caregivers are at increased risk of asthma-related hospitalization, more days with asthma symptoms, and poorer functional status.…”

“…Prior studies have found that asthmatic children with depressed caregivers report worse adherence to preventive asthma medications, less confidence and satisfaction during doctor’s visits, and increased healthcare utilization, including more frequent visits to the emergency department. (6, 18–22) This is particularly pertinent for young urban children, since they suffer the greatest burden of asthma morbidity (23) and are at high risk for inadequate preventive treatment. (24, 25)…”

Cow’s Milk Protein Allergy from Diagnosis to Management: A Very Different Journey for General Practitioners and Parents

“…Many of our parents reported feeling depressed about their child’s diagnosis, which has been shown to have impact on communication and also satisfaction with the service. In 2012, Fagnano et al [ 30 ] studied parents of children with asthma and the impact of depression on the communication between parents and health care professionals. In that study, 30% of parents had depressive symptoms, and that group was less satisfied with professional visits and felt that their needs were not met.…”

Mediating Roles of Resilience and Optimism between Work Demand and Psychological Distress among Pre-School Pupils’ Caregivers

“…Psychological distress have also been investigated among caregivers particularly of people with chronic obstructive pulmonary disease [90], patients with psychosis [91][92], patients with schizophrenia [93], cancer patients [94], symptomatic lung cancer patients [95], women with ovarian cancer [96], patients with lung cancer [97][98], and individuals with affective disorders [99]. Studies on psychological distress have also been done on caregivers of children with autism spectrum disorder [100][101][102][103] and children with asthma [104], children with a disorder of sex development [105][106]. However, not much has been done on caregivers of normal preschool pupils in Nigeria generally and in Ekiti State to be specific.…”